How much cartilage can be removed from a nose?

Reducing and refining the nose is a very common request.Kenneth Hughes, MDLos Angeles, CA.............

Cartilage removal or preservation in a rhinoplasty needs to be evaluated by a board certified plastic surgeon as each nose is different. In some cases cartilage may even be added for structural support.

There is always a balance between removing a reasonable amount of cartilage and creating a pleasing size/ shape of the nose while not removing excessive cartilage that results in a nose that doesn't breathe or that looks "done." You mentioned that you have thin skin which should enable significant sculpting and shaping or your nose. A bigger issue is created by very thick skin which can camouflage the meticulous shaping of the underlying cartilage. Seek a consultation with a rhinoplasty expert who should be able to perform simulations and give you some idea of the type of result you can possible achieve with surgery. I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

It is not so much about how much fat is removed but how it is reshaped for tip refinement. The nasal tip needs support to have a shape so some reduction may be needed but it is more important is how the remaining cartilage is shaped that leads to a more refined tip.  

A fat nose often refers to the globular tip which is often made of thick skin and a thick fatty subcutaneous layer.  The cartilages may make the tip bulbous and can be refined, but it usually is not a cartilage issue per se.

  Modern Rhinoplasty is not  about how much cartilage can be removed, but how much cartilage is left behind for structural support for the remainder of your lifetime. To reduce the bulbous tip, suture techniques are applied to the lower lateral cartilages. When the cartilages are excessively wide, a conservative amount of cartilage can also be removed. To narrow a wide bridge line, osteotomies are performed. For many examples and more information, please see the link and video below

It may not be necessary to remove a lot of cartilage but rather contouring the existing cartilage so that the underlying structure is maintained to achieve the desired narrowing and definition. I need to see pictures to suggest an appropriate approach.